20122315 shelley318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z7RB08 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
DT4000 (STANDARD CRASH)Reportable
TagsSchool Bus Related
NOActive School ZoneGovernment
Property
Reporting
ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
01
Time Notified
03:42 PM
Date Notified
12/23/2020
Time Arrived
04:11 PM
Date Arrived
12/23/2020
Crash Time
03:42 PM
Crash Date
12/23/2020
Investigating Officer/Deputy
DEPUTY MATHIAS HALBUR
Agency Crash Number
20122315
Primary Crash Document #Document Number Override
6VL0Z7RB08Additional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON DECEMBER 23RD, 2020, I DEPUTY MATHIAS HALBUR WAS ON DUTY FOR THE SAWYER COUNTY SHERIFF'S OFFICE. I WAS REQUESTED BY DISPATCH TO
RESPOND TO THE INTERSECTION OF HIGHWAYS 27 AND 70 BY DJ'S MART IN STONE LAKE REFERENCE A VEHICLE IN THE DITCH ON THE EAST SIDE OF THE
ROAD. THE CALLER WAS NOT INVOLVED IN THE INCIDENT BUT DID ADVISE THAT THERE WERE PEOPLE GETTING OUT OF THE VEHICLE THAT DID NOT
APPEAR INJURED. I ARRIVED IN THE AREA AND ATTEMPTED TO LOCATE THE VEHICLE, BUT I DID NOT SEE ANY VEHICLES IN THE DITCH. I DROVE INTO THE
DJ'S MART PARKING LOT AND OBSERVED A BLUE CHEVROLET MALBU WITH WI PLATES OF THE MALIBU HAD DAMAGE TO THE BUMPER AND THE
DRIVER'S SIDE HEADLIGHT. I ESTIMATED THE DAMAGE TO BE VALUED AT MORE THAN $1,000. I SPOKE WITH THE DRIVER OF THE VEHICLE,
- DOB: 10/7/ AND THE PASSENGER, - DOB: 9/21/ BOTH SAID THEY WERE NOT INJURED
AND WERE REMOVED FROM THE DITCH BY A PASSERBY. THE VEHICLE WAS DRIVABLE, BUT WITHOUT TWO FUNCTIONING HEADLIGHTS, AND A SEVERE
SNOWSTORM MAKING VISIBILITY AND ROAD CONDITIONS POOR, THEY WERE WAITING FOR A FAMILY MEMBER WITH TWO FUNCTIONING HEADLIGHTS TO
LEAD THEM BACK TO THEIR RESIDENCE. TOLD ME THAT HE WAS GOING NORTHBOUND ON STATE HIGHWAY 27 AND DUE TO THE ROAD CONDITIONS,
LOST TRACTION WHICH CONTRIBUTED TO THE VEHICLE GOING IN THE DITCH. TOLD ME THAT THE VEHICLE WENT INTO THE DITCH FACING NORTH
AND CAME TO REST FACING WESTBOUND, TOWARDS DJ'S MART. FATHER ARRIVED ON SCENE IN A VEHICLE WITH TWO FUNCTIONING HEADLIGHTS.
Crash Time 03:42 PM
Crash Date 12/23/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z7RB08 WISCONSIN MOTOR VEHICLE
CRASH REPORT
I PHOTOGRAPHED THE DAMAGE TO THE VEHICLE. THESE PHOTO WILL BE ATTACHED TO THE SPILLMAN CASE FILE. I INFORMED THAT I WOULD FILE A
REPORT FOR THIS, AS WELL AS A CRASH REPORT THAT GOES TO THE STATE OF WISCONSIN. I WROTE DOWN THE AGENCY CASE NUMBER AS WELL AS MY
NAME AND BADGE NUMBER AND PROVIDED THE INFORMATION TO I CLEARED FROM THE SCENE SHORTLY AFTER. A CRASH REPORT WILL BE
COMPLETED AND ATTACHE
Structure Type
NO STRUCTURE
Y Coordinate
5088744
X Coordinate
150534.875
Longitude
-91.502246639
Latitude
45.863484504
ON STH27 NB
146 FT N
OF STH70 WB
IN THE TOWN OF SAND LAKE
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
Crash Classification - Jurisdiction
NO SPECIAL JURISDICTION
Crash Classification - Location
PUBLIC PROPERTY
Relation To Trafficway
TRAFFICWAY - NOT ON ROAD
Animal Type
Weather Condition(s)
CLOUDY, SNOW, SEVERE WINDS
Environment Factor(s)
WEATHER CONDITIONS, VISUAL OBSTRUCTION (S), GLARE
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
WET, SNOW, SLUSH, ICE
Light Condition
DAYLIGHT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
First Harmful Event
DITCH
Crash Scene
Intersection Type
T-INTERSECTION
Junction Location
INTERSECTION-RELATED
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
CURVE RIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
STOP SIGN
Traffic Way
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
DITCH
Total Lanes
2
Speed Limit
55
Pre CrashTire
Mark
Direction Of Travel
WESTBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
2
Operating As EndorsementsVehicle Type
PASSENGER CAR01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITInitial Contact Point
11 - LEFT FRONT CORNER
Bus UseBody Style
4D - 4DR
Color
BLU - BLUE
Model
MALIBU
Year
2009
Make
CHEVROLET
Vehicle Identification Number
48300101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 03:42 PM
Crash Date 12/23/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z7RB08 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
RADISSON, WI 54867 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
11 - LEFT FRONT CORNER, 12 - FRONT
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
RUN OFF ROADWAY RIGHT02
Event
DITCH03
Event
04Distracted By
Injury
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
01 - FRONT ROW
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
RADISSON, WI 54867 , US
Race
WHITE
Date of Birth
10/07/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 03:42 PM
Crash Date 12/23/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z7RB08 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #
Distracted By Action
NOT DISTRACTED
UNITNon Motorist
INDIVIDUALDistracted By
Injury
Distracted By Action
Distracted By Source
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00201 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
09 - RIGHT
Row
01 - FRONT ROW
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License NumberAddress
RADISSON, WI 54867 , US
Race
HISPANIC
Date of Birth
09/21/
Sex
FEMALE
Citations Issued
0
Passenger
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 03:42 PM
Crash Date 12/23/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z7RB08 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00201Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #UNITNon Motorist
INDIVIDUALCrash Time 03:42 PM
Crash Date 12/23/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.